【摘要】 目的：探讨降糖保肾方治疗早期气阴两虚兼血瘀型糖尿病肾病（DN）的临床疗效及对患者肾功能、胰岛素抵抗、尿微量白蛋白的影响。方法：选取2022年6月～2023年12月期间某院收治的80例早期气阴两虚兼血瘀型DN患者作为研究对象，采用随机数字表法分为对照组和观察组，每组40例。对照组患者给予常规西药治疗，观察组患者在对照组治疗基础上联合降糖保肾方治疗，两组均连续治疗3个月。比较两组患者中医证候积分、尿蛋白指标[尿微量白蛋白/肌酐比值（UACR）、糖化血红蛋白（Hb A1c）]、空腹血糖（FBG）水平、肾功能指标[估算肾小球滤过率（eGFR）、血肌酐（SCr）、血尿素氮（BUN）]、空腹胰岛素（FINS）、稳态模型评估胰岛素抵抗指数（HOMA-IR）、炎症指标[降钙素原（PCT）、C反应蛋白（CRP）、白介素-6(IL-6)]及中医证候疗效。结果：治疗后，两组患者中医证候积分、UACR、HbA1c、BUN、SCr、FINS、HOMA-IR、PCT、CRP和IL-6均降低（P<0.05），且观察组低于对照组（P<0.05）;eGFR均升高（P<0.05），且观察组高于对照组（P<0.05）。观察组患者临床治疗总有效率（97.50%）高于对照组（85.00%,P<0.05）。结论：降糖保肾方联合常规西药治疗早期气阴两虚兼血瘀型DN患者效果较佳，可有效改善临床症状、血糖及肾功能，减轻胰岛素抵抗及炎症反应。更多还原

【Abstract】 Objective: To investigate the clinical efficacy of hypoglycemic and kidney-protecting formula in treating early stage diabetic nephropathy(DN) with Qi-Yin deficiency and blood stasis syndrome, and its effects on renal function, insulin resistance and urinary microalbumin in patients. Methods: A total of 80 patients with early stage DN of Qi-Yin deficiency and blood stasis syndrome admitted to a hospital from June 2022 to December 2023 were enrolled and divided into the control group and the observation group by the random number table method, with 40 patients in each group. The control group received conventional western medicine treatment, while the observation group was additionally administered hypoglycemic and kidney-protecting formula on the basis of the control group’s treatment. Both groups were treated continuously for 3 months.The traditional Chinese medicine(TCM) syndrome scores, urine protein indices [urinary albumin/creatinine ratio(UACR), glycosylated hemoglobin(HbA1c)], fasting blood glucose(FBG) level,renal function indices [estimated glomerular filtration rate(eGFR), serum creatinine(SCr), blood urea nitrogen(BUN)], fasting insulin(FINS), homeostasis model assessment of insulin resistance(HOMA-IR), inflammatory indices [procalcitonin(PCT), C-reactive protein(CRP), interleukin-6(IL-6)] and TCM syndrome therapeutic efficacy were compared between the two groups. Results: After treatment, the TCM syndrome scores, UACR, HbA1c, BUN, SCr, FINS, HOMA-IR, PCT, CRP and IL-6 were decreased in both groups(P<0.05), and the values in the observation group were lower than those in the control group(P<0.05). The eGFR was increased in both groups(P<0.05), and the value in the observation group was higher than that in the control group(P<0.05). The total clinical effective rate in the observation group(97.50%) was higher than that in the control group(85.00%,P<0.05). Conclusion: Hypoglycemic and kidney-protecting formula combined with conventional western medicine demonstrates superior efficacy in treating early stage DN patients with Qi-Yin deficiency and blood stasis syndrome. It can effectively improve clinical symptoms, blood glucose and renal function, alleviate insulin resistance and inflammatory response.更多还原